Planes A, Vochelle N
Clinque Radio-Chirurgicale du Mail, La Rochelle, France.
Orthopedics. 1997 Feb;20 Suppl:18-21.
A prospective, randomized, double-blind trial was performed in total hip replacement patients to document the risk of deep vein thrombosis (DVT) after hospital discharge, and to assess the efficacy of sustained antithrombotic prophylaxis. In a total of 179 patients receiving enoxaparin 40 mg/day during hospitalization, those without venogram-proven DVT at discharge were randomly assigned to continue prophylaxis with enoxaparin (N = 90) or receive placebo (N = 89). At the end of 21 days' treatment, intention-to-treat analysis in 173 evaluable patients demonstrated a significantly lower incidence (P = 0.018) of DVT in the enoxaparin group (7.1%; N = 6) compared with the placebo group (19.3%; N = 17). These findings were confirmed by perprotocol analysis in 155 patients. Minor bleeding episodes occurred in three patients in the enoxaparin group and one in the placebo group. Thus, total hip replacement patients have a significant risk of developing DVT after hospital discharge. Continued prophylaxis with enoxaparin is effective in reducing this risk.
对全髋关节置换患者进行了一项前瞻性、随机、双盲试验，以记录出院后深静脉血栓形成（DVT）的风险，并评估持续抗血栓预防的效果。在总共179例住院期间接受每日40 mg依诺肝素治疗的患者中，那些出院时静脉造影未证实有DVT的患者被随机分配继续接受依诺肝素预防（N = 90）或接受安慰剂（N = 89）。在21天治疗结束时，对173例可评估患者的意向性分析表明，依诺肝素组的DVT发生率（7.1%；N = 6）显著低于安慰剂组（19.3%；N = 17）（P = 0.018）。155例患者的符合方案分析证实了这些结果。依诺肝素组有3例患者发生轻微出血事件，安慰剂组有1例。因此，全髋关节置换患者出院后有发生DVT的显著风险。继续使用依诺肝素进行预防可有效降低这种风险。
